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Non‐invasive brain stimulation for fine motor improvement after stroke: a meta‐analysis
Author(s) -
O'Brien A. T.,
Bertolucci F.,
TorrealbaAcosta G.,
Huerta R.,
Fregni F.,
Thibaut A.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13643
Subject(s) - transcranial magnetic stimulation , medicine , meta analysis , stroke (engine) , transcranial direct current stimulation , brain stimulation , confidence interval , randomized controlled trial , stimulation , physical medicine and rehabilitation , publication bias , mechanical engineering , engineering
The aim of this study was to determine whether non‐invasive brain stimulation ( NIBS ) techniques improve fine motor performance in stroke. We searched PubMed, EMBASE , Web of Science, Sci ELO and OpenGrey for randomized clinical trials on NIBS for fine motor performance in stroke patients and healthy participants. We computed Hedges’ g for active and sham groups, pooled data as random‐effects models and performed sensitivity analysis on chronicity, montage, frequency of stimulation and risk of bias. Twenty‐nine studies (351 patients and 152 healthy subjects) were reviewed. Effect sizes in stroke populations for transcranial direct current stimulation and repeated transcranial magnetic stimulation were 0.31 [95% confidence interval (CI), 0.08–0.55; P = 0.010; Tau 2 , 0.09; I 2 , 34%; Q , 18.23; P = 0.110] and 0.46 (95% CI, 0.00–0.92; P = 0.05; Tau 2 , 0.38; I 2 , 67%; Q , 30.45; P = 0.007). The effect size of non‐dominant healthy hemisphere transcranial direct current stimulation on non‐dominant hand function was 1.25 (95% CI , 0.09–2.41; P = 0.04; Tau 2 , 1.26; I 2 , 93%; Q , 40.27; P < 0.001). Our results show that NIBS is associated with gains in fine motor performance in chronic stroke patients and healthy subjects. This supports the effects of NIBS on motor learning and encourages investigation to optimize their effects in clinical and research settings.